My boy Monty was diagnosed with diabetes, can you help me?

Hi friends.
My name is Mikala, from Denmark, and I am the cat mom of a special little boy and girl named Monty and Molly.
They are both born with a chromosome abnormality and they are not siblings.
In October 2020 Monty was diagnosed with diabetes and I have been trying my best to navigate with all the information from my vets but the last month has been hard, because Monty's blood sugar is not under control.
I need all the helt and guidance I can get. <3



Important facts about Monty:

From 2013-2015 Monty had blood in his urine and was on Urinary diet from Royal Canin. The vets tried to figure out why he has blood but it turned out to be from stress from a cat he lived with in our home. The cat was a rescue and got a wonderful perfect home with a woman with no cats so that is perfect.

In 2015 Monty's blood samples showed that he had a little too high SDMA (https://www.idexx.dk/da/veterinary/reference-laboratories/sdma/) and it kept on changing from about 10-18 and back again and the limit is 14. All his other kidney leves are normal.
Monty started on Royal Canin Renal to support his kidneys. He loves dry food and I am trying to get him to eat wet food and is giving him unlimited dry food and wetfood twice a day. He eats around a spoonfull wetfood twice a day only.

In March 2018 Monty was diagnosed with epilepsy and he is has been on Phenobarbital ever since to stop the seizures. His seizures was weird looking and not how I would have imagined epilepsy look like. He was acting like he was stoned and was walking weird and in slowmotion and like he couldn't seem to find the ground with his one paw. Since Monty started on his medication I havn't seen a seizure and I feel very relieved.
Monty is still eating Royal Canin Renal to support his kidneys. He loves dry food and I am trying to get him to eat wet food and is giving him unlimited dry food and wetfood twice a day. He eats around a spoonfull wetfood twice a day only.

October 2020 Monty is drinking water like CRAZY and he is not eating a whole lot. A blood sample shows that he has diabetes because his blood sugar is crazy high.
Monty starts on insulin Levemir and has been on that since.
The vets told me to change food to Royal Canin Diabetes wet and dry food and like always, Monty doesnt care for wet food and I have been trying to feed him wet food twice a day with unlimited dry food. About a month ago I started to offer him wet food four times a day like I have also been measuing his blood sugar four times a day instead of two times a day before insulin.

You can find all his numbers from the last month in my sheet.
How in the world do I help my boy? I feel like I need to change his diet and maybe that will help? But how do I find a diet he likes that is also supporting his kidneys?
If you have any advice it would make me very happy but please remember that I am all new to this diabetes world and I love my boy so much and I will do anything for him and I am very nervous and sensitive when it comes to his health.
Monty and Molly are my world.


Love and Happiness,
Mikala

UPDATE 4/15-21 ON FOOD:
Started giving him 50/50 Ziwipeek dry food and the plan is to get him on 100% Ziwipeek as the only dry food. He is still eating about a tablespoon wet food Royal Canin Diabetic before insulin so at 6am and 6pm. That's all I can get him to eat of the wet food. I am desperatly looking for a low carb wet food he likes! I have tried so many different you have no idea and he refused to eat ANY OF THEM! He loves Weruva Paw Lickin Chicken and I am trying my best to get it home from US to Denmark! If and when that happens he will be on that full time!

 

@tiffmaxee can you help these wonderful people?

 

I felt i had to reply to you due to your comments on how you thought your boys seizures were wierd, plus uncontrolled sugars. Has your vet considered acromegaly? Only a thought

 

I don't know what that is but I just googled it and I don't think so. His limbs are all looking normal size.

 

Theres lots of symptoms with it and not all cats have all symptoms. It was only a thought as uncontrolled sugars and seizures can be symptoms, so i am told.

 

Welcome. His numbers aren’t horrible. His food is high carb and dry which is not the best for a diabetic cat. Do you have the latest labs and if so please input on the ss tab for labs. If early CKD you don’t need renal food as it sounds like stage 1 or 2. High bg above renal threshold will harm the kidneys.

I suggest you test a little differently. The nadir, ,lowest point in the cycle , won’t always be mid cycle. When you saw the 79 at night another test was needed as he could have dropped lower. He then bounced to pink from being in a lower number than used to. Can you do an 18 hour curve testing every 3 hours for 18 hours tomorrow or a 12 hour curve testing every 12 hours for a cycle?

The dosing method we would have you use is SLGS. I’m going to give you the link to read about it.

Good job testing. We just need you to test at different times. Cats on Levimir, an excellent insulin, often nadir late in the cycle. Some even reach nadir at shot time.

When you can add to your signature his health issues, meter, and food.

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

 

I love that you are asking questions because maybe that could be it <3

 

Thank you so much <3

I will get the latest labs and add them in here. What does CKD means? What does bg means in this sentence? "High bg above renal threshold will harm the kidneys."
I will start tomorrow and do an every 3 hour mesauring. What is this? "12 hour curve testing every 12 hours for a cycle?" I can start tomorrow morning by giving him insulin and then measure every 3 hours for 24 hours if you like?

What is SLGS?

What is "meter" in your sentence? "When you can add to your signature his health issues, meter, and food."

I am sorry I am asking so much. I am just very new and have no idea what all the terns means.

 

The lack of control is very likely due to food choices and I suspect some bouncing. Before further testing it would be good to make some adjustments. Just my two cents fwiw.

 

What does this mean?

 

CKD is chronic kidney disease. Bg is blood glucose.

You can either do a 12 hour curve testing every 2 hours after insulin for 12 hours or an 18 hour testing every 3 hours for 18 hours.

SLGS is the dosing method used here when feeding dry food. I gave younger link above.

Meter is what you use to measure the sugar. Is yours one for pets or humans? On the ss also add that you are using Levimir.

 

I’m sorry but just realized you are in Denmark so probably don’t understand a lot of English. I wrote just my two cents for what it’s worth. That just means it’s my opinion. I will make sure to be more clear.

 

Hahaha I'm sorry and thank you so much <3 I am so lost!

 

Now I have made a signature

 

Should I change food? And what kind of food should I give him? Should it be a little low in protein? And can I feed him ziwipeak to see if he likes that dry food?

 

You want a lower phosphorus food but low carb. It would be best to get him to eat wet food. You could try putting some freeze dried over the wet. At early kidney disease vets now say you don’t usually go to a kidney diet. Maybe if the glucose comes down the kidney values will decrease as well.
Have you looked at tanyascrf? It’s an excellent site for kidney disease and has a food chart. The foods would be different in your country but some might be the same.

 

Here’s the link.

https://felinecrf.org/catfood_data_overview.htm

 

Hi
Now we have made measurements every 3 hours the last 24 hours and written it in his sheet.
I don't think it looks good but what do you think?

 

Important update:

Monty's bloodsugar went higher a few weeks ago and we suspect it maybe to be because we stopped giving him calming supplements because we suspect him having stress. We moved from our house into an appartment December 2020 and after we moved Monty's blood sugar went from being super nice and low to be very high like in 15-18 and the insulin didn't seem to work. The vet told us to give him calming supplements and after a few weeks his blood sugar went back to being much lower. He still needed insulin at least once a day but it was going really good. Now we stopped giving him supplements and his blood sugar went up again. So maybe we can conclude that due to his stress the insulin doesn't work that well. We have of course started giving him the calming supplements again and we will wait and see. Hopefully his blood sugar will go down again and be like it were about a month ago.

 

Good job with tge curve. You increased which was the right thing to do. Now hold the dose for 7 ways and do another curve. We find that almost always Levimir needs to be dosed every 12 hours unless too low to shoot. Consistency is important. If too low to shoot we drop the dose so the cat gets insulin every 12 hours. I honk the renal food being higher carb is causing the bg to be higher.

 

And we just found out that the syringe isn't primed before the shot, and juice is put back in the pen. That's fixed now.

Am I right that in terms of the kidneys the problem isn't protein but phosphorus?
The UK food list has phosphorus content listed too.

 

Yes, it’s the phosphorus you want lower but in stage 1 and 2 you don’t need to be as strict and I think Monty is early CKD.

 

Perfectly, thank you Elise
Is it beneficial to lower it before it becomes necessary?

 

It’s good to try and find the lowest phosphorus lower carb food but you usually don’t need renal food. Look at tanya’scrf.org, all you want to know and more on CKD.

 

Thank you both so much

When the box with the number of phosphorus in the food, does that mean that there isn't any phosphorus in the food or people just don't know?

https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

 

Bump

 

We fixed the low this PM, and the new dose is 0.75U.
Monty stayed up on his own for two hours without help, so his mom and dad is taking a well deserved nap

Just in case anyone notice the lime on his SS. His SS will be fixed tomorrow when I have time to explain how to stack the numbers properly.

 

Hi, welcome. So glad you're here. You will get good help for Monty.

I think you're asking when the box is empty, is it because the food has no phosphorus?
What it means is it wasn't calculated by whomever did the food chart. All of the foods have some amount of phosphorus in them. I personally try to feed Butters a food with 1% or less phosphorus. She is diagnosed stage 2 CKD.

I don't know if anyone mentioned this to you yet, but low carb food is <10%. So when you're looking at the list for low carb wet foods to try, you want to stay for sure <10% carbs and choose ones with a lower phosphorus number. I personally stick with <5% carb food for Butters.

 

Hi Mikala. You will never have to be sorry for asking questions here, we're all here for the same reason and we all started out the same way. Some of us had great veterinarians and some of us had to learn all of this ourselves but you're here now. We share what we know and we feel what you feel. Now you, Monty and Molly are part of our family. Most of us are from North America but you are not alone or far away. SashaV is also from Denmark so she can help with things like food we don't get here. Because of the time difference you might not get your questions answered right away but you're off to a good start.

 

Thank you so so much <3 It is so kind of you. I must say that I am struggling a little bit feeling like a bad mom because I just listened to my vets and also because everything is so new in here and I am reading so much and trying to navigate on the page with all the informations

 

I want to ask you guys if it is correct that Weruva Paw Lickin' Chicken is a good food for Monty? I found it in here: https://docs.google.com/spreadsheets/d/1nMBzt57Zi0PcAJ-gSt0NxrTyc3Twi7A0L8o2H2gGkoM/edit#gid=0
It says 196 Phosphorus - mg/100kcal. What does that mean?

I have tried that wet food a few years ago and that is one of the two ONLY types of wet food Monty LOVES! So if it is a safe food for him I have NO problems at all! He preffers this over dry food anytime!

 

Paw Lickin Chickin is great. Anything that is less than 250 mg/100 kcal of phosphorus is good. Weruva has some great options for CKD kitties. Jeopurrdy Licious, Steak Frites, Family Food, On the Cat Wok, and Goldie Lox are a few others.

 

That is AWESOME!!!!
That is just what I need! He LOVES that food!
I will write my friend in US right away and get him to send like 1000 cans!

 

Weruva Paw Lickin' Chicken says 196 Phosphorus - mg/100kcal. Is that too hight according to your Butters stage 2 CKD? Btw what an adorable name she has

 

Lol thanks. I looove the photo of your kitties with the drawings of them. Those are awesome!
Not too high. And that food fits the bill for low carb, too. I hope Monty is excited to eat the 1000 cans you're going to buy for him!

 

Welcome Mikala, you couldn't have found such an amazing , caring group of people here. We are all like family. I'm glad Monty loves the Weruva food.
How about Molly does she like wet food.
They both are adorable kitties.
I wish you and your kitties all the best ♥

 

Mikala, did you paint those pictures of Monty and Molly? If you did then you must be very talented!